Mrs. Katilyn Marie Davis
Nurse Practitioner - Gerontology
10617 Kyle Ave N
Brooklyn Park
, Minnesota 55443-1249
Mrs. Katilyn Marie Davis
Nurse Practitioner - Gerontology
10617 Kyle Ave N
Brooklyn Park
, Minnesota 55443-1249
(952) 345-3213
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mrs. Katilyn Marie Davis
- 5320 W 23rd St Ste 130
- St Louis Park, MN
- Zip : 55416-1670
- Phone : (952) 345-3213
Second Address
- Mrs. Katilyn Marie Davis
- 10617 Kyle Ave N
- Brooklyn Park, MN
- Zip : 55443-1249
- Phone : (612) 802-4972
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | R188521-1 | MN |
National Provider Identifier
| NPI | 1043395361 |
|---|---|
| Provider Name | Mrs. Katilyn Marie Davis |
| First Address | St Louis Park, MN 55416-1670 |
| Second Address | Brooklyn Park, MN 55443-1249 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/10/2006 |
| Last Update Date | 22/04/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.